Claim

Malaysia  |  Kuala Lumpur

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Responsibilities

To manage Major and Minor (reimbursement) claims team for PruBSN claims, as well as claim customer support unit.
? To monitor and review work systems and processes for the effective and efficient operations of the section and implementing process improvements where appropriate.
? Accountability in staff development by providing internal training plan or refresher training and continuously giving technical advice, leadership and motivation whenever required.
? To measure the quality and individual error management in the team in order to categorize the training needs.
? Ensures section/unit complies with all regulatory (internal and external) and corporate requirements.
? Responsible and be accountable on all Claims committee cases from presentation and till completion.
? Involved in project organized by Department or Company and complete the projects within the timeline.
? Perform claims assessment and approval on all types of claims based on authority limit and ensure claims (benefit) amount are paid within the TAT for claims process.
? Monitoring completion of daily, monthly and ad-hoc statistic & analysis for reporting to management
? Involved in new product development by product specs, business requirement and certificate document review as and when required. Manage and participated in UAT as and when necessary upon new product launched or system enhancement. Review SRF and necessary system enhancement raised.
? Monitoring accountability in capping on all complaining index from all touch point on directly and indirectly related to claims matters


Requirement

Tertiary education preferably in Biomedical/Biotechnology/Bioscience or any related fields.
? Minimum 8 years of experience in Claims operations with managerial skills.
? Passing Professional Examinations: Life insurance qualifications eg. ACII, AMII,AAII, FLMI


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